Nerve Disorders: Types, Causes, Symptoms, Treatment, Diagnosis

Nerve disorders are a type of conditions that primarily affect the nervous system and show nerve related symptoms. Nerves are present all over the body and any condition that affects the nerves or any damage caused to the nerve can result in undesirable symptoms.

Nerve disorders can be considered as neurological conditions occurring due to genetics, infections, nutritional deficiencies, injuries or environmental factors.

Nerve disorder can be of different types depending on the cause and the type of nerves affected.

• Degenerative Nerve Disorders – Conditions affecting the nerve that result in difficulty in movement, co-ordination, balance and movement. These can occur due to medical conditions, tumor, alcoholism or other causes and also as a part of aging process. Example, Alzheimer’s disease.
• Peripheral Neuropathy – Peripheral nerves are affected leading to numbness and tingling in hands, legs, fingers and toes. Spasms and weakness of muscles may also be noted. Those indulging excessively in alcohol, diabetics and nutritionally deficient people may be at an increased risk of peripheral neuropathy. Example Diabetic neuropathy.
• Weakness and Paralysis – Conditions that affect a particular nerve, due to injury, compression or infection can cause the nerve to be permanently damaged. This can result in paralysis and loss of function of the area supplied by the nerve. For example, Bell’s palsy.
• Others – Many other conditions that can affect a nerve and cause nerve disorder include infections like shingles; neuro-muscular problems like muscular dystrophy, myasthenia gravis, muscular spasm; fibromuscular problems; nerve damage due to injuries, accidents, surgical procedures, etc.; carpal tunnel syndrome and sclerosis. Certain types of headaches, migraine and conditions affecting speech and other sensory functions are also considered as problems arising out of nerve disorders. Rarely, exposure or ingestion of certain substances too can contribute to nerve toxicity and damaged nerves.

The causes of nerve disorder widely vary and so do the presenting features. However, a common characteristic of nerve disorder is that the function of the area supplied by the damaged nerve may be compromised.

• Pain is commonly present when the nerve disorder is marked by nerve irritation. Over-sensitivity of the part, pain in the surrounding area, difficulty in moving the body part.
• One of the symptoms of nerve disorder is that the muscles in the area of nerve damage usually show signs of injury, have pain and spasms, cramping or twitching. Affected muscles may get easily fatigued and raising hands or walking for long may be difficult.
• Difficulty in co-ordination, holding or lifting objects, problems with fine motor skills like buttoning or writing may be seen as a symptoms of nerve disorder.
• In more advanced cases of nerve disorder, muscles involved in breathing may get affected causing difficulty in breathing, shortness of breath and sometime affect digestion as well.

If a nerve around the face is affected, movements of eyes, lips and tongue may change. Chewing, swallowing and speech may get affected. Eyelids may twitch or droop. Pain may be present around or behind the ears, the jaw joint movements may cause pain and there may be increased sensitivity to noise.

Nerve damage in the spine affects the hands or the legs. Depending on the cause and the condition of the nerve disorder, there may be burning, shooting type of pain in the limbs. Numbness and tingling or pins and needles is often noted. Holding or grasping may be difficult and things may fall off from hands. Sensation of hot and cold in hands or legs may get altered. In more advanced cases, the functioning of bowel and bladder may also get affected, more commonly when nerves in the lumbar spine are involved.

Other symptoms of nerve disorder may include changes in regular body functions, affected digestion, excessive sweating, disturbed sleep, changes in blood pressure and headaches. Altered level of alertness, seizures, difficulty in reading, writing or talking, poor cognition, unexplained pain, dizziness, vertigo, inability to concentrate or understand and behavioral problems can also be a result of nerve disorders.

Nerve disorder can result from a variety of causes. Hence, a careful history taking, clinical examination and assessment is essential. Any history of injury, previous surgery, infections, exposure to particular allergens, metals, toxins, recent medications etc. need to be evaluated.

Clinical examination involves understanding the symptoms and checking the affected parts for reflexes, sensations and functioning. Investigations like nerve conduction studies and electromyography can help to find the signal passage through the nerves and the activity of muscles. Imaging studies and scans may be done to rule out other causes. In some cases more advanced studies like nerve biopsy and skin biopsy may be considered.

Nerve disorder or neuropathy can arise out of nerve compression, nerve irritation or nerve damage due to various causes. The aim of treatment of nerve disorder is to treat the underlying cause, reduce pain and other symptoms and protect from further functional damage.

Medical treatment is given to soothe irritated nerves, relax muscles and relieve pain. Nutritional supplements, pain killers, muscle relaxants and anti-depressants anti-epileptic drugs are usually given for nerve disorders.

Specialist referrals are considered depending on the symptoms, causes and the parts affected. Steroid injections may be advised in case of single nerve injury or when conservative treatment fails. Surgical options may be considered wherever appropriate to correct nerve entrapment like removal of tumor or resolving spinal disc problems.